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Is Fixing Pediatric Nail Bed Injuries With Medical Adhesives as Effective as Suturing?

A Review of the Literature

Edwards, Sarah, BMBS, PGCME, DMHSA*†; Parkinson, Leesa, PhD, FRCEM, MBBS, BSc (Hons)

doi: 10.1097/PEC.0000000000000994
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Objectives Nail bed injuries are common in children, with nail bed damage accounting for 15% to 24% of fingertip injuries. Our objective was to see whether medical adhesives, the cyanoacrylates including Histoacryl and Dermabond, could be used to fix nail bed lacerations as opposed to doing a primary repair with sutures, thus potentially being a quicker method for repair in the emergency department for these injuries.

Methods We conducted a literature review using the search engines MEDLINE, PubMed, Web of Science, and Google Scholar, and the references within these articles were also integrated. All articles in English were searched. Search terms included “nail bed repair,” “nail bed laceration repair,” and “cyanoacrylate.”

Results A total of 6 articles were found using the previously mentioned search terms. Four articles using 2-octyl cyanoacrylate or Dermabond for the repair of nail bed injuries were found, with 2 additional articles describing the use of Histoacryl—n-butyl-2-cyanoacrylate—for nail injury repairs.

Conclusions The 6 articles discussed in this article include approximately 118 patients' worth of data including a mix of adult and pediatric patients. Despite the small numbers and variety of types of study, it is encouraging that there are so many positive results. Cryoacrylates such as Dermabond or Histoacryl maybe useful to assist with nail injuries in children. Therefore, we feel that using a medical adhesive is as effective as suturing nail bed injuries in children.

From the *Betsi Cadwaladr University Health Board, Emergency Department, Wrexham Maelor Hospital, Wrexham; and

Betsi Cadwaladr University Health Board, Emergency Department, Ysbyty Gwynedd, Bangor, Wales, United Kingdom.

Disclosure: The authors declare no conflict of interest.

Reprints: Sarah Louise Edwards, Betsi Cadwaladr University Health Board, Emergency Department, Ysbyty Gwynedd, Bangor, LL57 2PW Wales, United Kingdom (e-mail: sarah.louise.edwards@wales.nhs.uk).

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